PUPPPS (Pruritic Urticarial Papules and Plaques of Pregnancy): To Hell and Back

I had the rash from hell also. I posted about my experience ( here ). It was an absolute nightmare and I can completely relate to Clare’s story!

-Krystle K 

By Clare Dixon || Guest writer for The Snap Mom

After all the problems that occurred with my first pregnancy, I didn’t think it could be much worse to have another baby. I was very excited during my second pregnancy. I felt great, morning sickness was very minimal, and I never got a single migraine. In my mind it was a perfect pregnancy. Boy, was I wrong!

It was in the early hours of the morning on Monday, July 22, 2013. I was 38 weeks and 2 days pregnant with my second daughter, Millie. I had been tossing and turning all night, the kind of sleep where you are half awake but not enough to fully know what’s going on to completely wake up. I subconsciously noticed around 3 am that my inner thighs had been itching for quite awhile. By 5 am I was wide-awake from this annoying itch and got up to investigate. I turned on the light; my inner thighs and backs of my arms were covered in big swollen rashes, and I just couldn’t stop itching. It was like nothing I’d ever seen before. The itching quickly became unbearable. I was supposed to have my final OB appointment at 1 pm that day. I was already tempted to go to the ER because I couldn’t stand the constant irritation of the itch, and it was spreading very quickly.

IMG_20130727_232616 IMG_20130726_050253

I sat in an Epsom salt bath and an oatmeal bath. I applied coconut oil, calamine lotion, and cold compresses – the list goes on. I did everything I could think of and tried whatever I could find online to naturally treat “hives” before I took any type of medicine. Mackenzie, my first born, was three at the time; I still had to get her to school and myself to work for the day. I had been crying most of the morning from the annoyance and consistency of the itching. While at work, it spread a lot more. It was finally time to go to my appointment. The doctor didn’t say much. He told me it was hives and that I was just having a random reaction to something, but it would go away. This was the last time I’d see him before I delivered at my scheduled c-section the following Monday. I started crying because he thought of it wasn’t a big deal and just sent me on my way. My gut feeling told me that it wasn’t just your average case of hives. He prescribed a steroid cream for me after I begged for something to help ease the itching. I was very hesitant to use it, but by this point, I was desperate and willing to try anything. I rushed to pick up the cream and applied it all over myself in the car while driving to get my daughter from school.

It was now about 5 pm; the cream had done nothing. I’d been sitting in cold, oatmeal and Epsom salt baths for the past hour. Any heat made the rash 100x worse and more unbearable. At this point, minutes felt like hours. It was all over my entire body, on my legs, arms, butt, behind my ears, between my toes and fingers, tops of my feet, and palms of my hands. It was literally everywhere! I’d almost used the whole tube of steroid cream already.

IMG_20130722_181054 IMG_20130722_154708

I’d been crying for hours, and my husband and mom were working late. I had called my OB two more times telling him it was getting much worse and that I couldn’t take much more. He prescribed another cream and told me to try Benadryl again. Both doses of Benadryl did nothing and neither did the cream. It was 7 pm before my mom could come over and help out with Mackenzie. She’s been a nurse for over 25 years and had never seen anything like this. She didn’t know what else to suggest to help me. We decided it was time to go to the ER. My husband finally got home around 8; I had called him 50+ times that day crying and saying that I didn’t know what to do and that no one was able to come help me. He never said it, but I got the impression he thought that I was overreacting and that it wasn’t as big a deal as I was making it out to be. When he came home, he realized how bad it was. He was speechless.

My mom took me to the Doctors Hospital ER. When I was taken back, the nurses all came over. They were staring and wondering what it was because they’d never seen anything like it before. By now it had begun to spread to my face. They quickly hooked me up to an IV of Benadryl and covered me in ice packs and cold washcloths. About 30-45 minutes later I FINALLY had some relief for the first time in over 15 hours. The swelling died down, the itching lessened, and I was finally calm enough to fall asleep for a little while. They decided to send me home since it had eased so much. They advised me to continue with the creams and to take Benadryl every four hours or as needed if I felt the itching coming back.

IMG_20130723_233940 IMG_20130723_185221

Less than 30 minutes after being home, it all flared back up again, and I was back to square one. I’d used the creams and taken Benadryl. I had ZERO relief. It was after midnight, and I had to call my OB again, I was so emotional at this point, 38 weeks pregnant and dealing with this dang rash for 24 hours, I just couldn’t stop crying or hold myself together. He told me to go to Triage at SMH. I called my mom, and she met me there. My husband stayed home with Mackenzie. When I arrived, they hooked me up to the Benadryl IV again after I told them that I had already been to the ER once tonight and that the IV had helped me the most. Hours went by, and doctors came and went. No one could give me an answer about what it was until finally one doctor said it was contact dermatitis. I looked it up on my phone, but again my gut feeling told me it wasn’t the answer. The information online didn’t fully add up to everything I was experiencing. Long story short, my OB finally figured out that it was Pruritic Urticarial Papules and Plaques of Pregnancy, better known as “PUPPPs”.

IMG_20130723_215755 IMG_20130723_035344

(http://www.whatispupps.com/WhatIsPUPPS.html)

What is PUPPPs?

It is a treatable but not curable condition that occurs in about 1 in every 200 pregnancies. Certain studies have revealed that this condition is more frequent in women carrying boys although no formal research has been conducted. Statistics cite that 70% of PUPPPs sufferers deliver boys. However, I fell into the 30% who delivered a girl.

The only way to finally stop the rash is by delivering the baby. Even then, it gets worse before it gets better. After much thought, we decided I could not go on another week in this condition and planned for my c-section at 11 am that day, July 23. I still had the Benadryl IV going throughout delivery and post-delivery for a few more hours. Once they stopped the IV, I was put on a steroid dose pack. Even though I was told it would get worse before it got better, I really didn’t believe that it could get worse. But it definitely was! Post-delivery was terrible. I endured the pains from surgery on top of the worsening rash without the Benadryl anymore.

Let’s just say I wasn’t very happy or pleasant to be around.

Four days later, I was sent home. I had made the decision to encapsulate my placenta. I was eager to get home to try the capsules out. I had suffered from PPD pretty badly after my first baby and also had had a very hard time producing milk. I was determined to kick those two things in the butt with my placenta pills. My rash had finally become bearable, the itching was tolerable, and it was clearly starting to go away. I started taking my placenta pills, and in less than an hour, I was completely swollen head to toe with the rash all over me again. It took me a couple days to figure out that the only thing I had done differently was to take my placenta pills. All the hormones from my pregnancy were still in those pills, and when I took them, the PUPPPs came back in full force. I decided to wait at least two weeks before trying to take another one. I took it very slowly with the dosage, and in the end, it worked out, and I survived to tell the story.

IMG_20130724_151428

Needless to say, I am TERRIFIED to get pregnant again. Since I’ve suffered from PUPPPs already, I feel that my body is much more susceptible to getting it again. If I were to get PUPPPs at an earlier stage of pregnancy, I don’t know how I would handle it. I couldn’t even last over 48 hours.

I even itched myself the entire time I was writing this article!